Fixing Google Ads Cannibalization for Multi-Location Dental Groups

Question 1

How do I know if my dental group's Google Ads locations are bidding against each other?

Accepted Answer

According to groas, the sign was that locations within the same network bid against each other in the same auctions because a single dental implants campaign targeted all three metros and a general dentistry campaign did the same. The article states all 12 locations were functionally bidding against each other with location bid adjustments layered on top, so high-performing locations ate most of the roughly $80K per month budget while others were starved. The article reports office managers complained, “We’re getting leads, but they’re not for us,” because blended data hid whether a lead cost $40 or $140 in Market A.

Question 2

How should Google Ads campaigns be structured for a multi-location dental group?

Accepted Answer

The article recommends giving every location its own campaign set, with budgets allocated at the market level and then distributed to location campaigns based on patient capacity and target acquisition volume. According to groas, Location A’s campaign only served Location A’s radius, with negative geo-targeting preventing overlap. For the group’s three metros this meant going from roughly 8 campaigns to over 30, giving clean data on what each location produced.

Question 3

How should we set up conversion tracking so Google Ads optimizes for booked appointments?

Accepted Answer

According to groas, the group replaced counting any call over 30 seconds as a conversion with a hierarchy weighted by relationship to a booked appointment. The article states the primary conversion became appointment booked through the scheduling system, the secondary conversion became a phone call over 90 seconds where the caller mentioned a specific service, and form fills, direction requests, and short calls became observation-only. The article positions this shift from “any call over 30 seconds” to “booked appointment confirmed in the PMS” as changing what the algorithm optimized toward.

Question 4

How should we set bidding targets when each location has different patient economics?

Accepted Answer

The article recommends setting a separate tCPA target for each location based on average revenue per new patient for that location’s service mix. According to groas, the implant-heavy suburban office could bid aggressively while the general dentistry downtown location bid conservatively, because a suburban patient with a high implant mix could be worth three times a downtown cleaning patient. Targets were reviewed monthly and adjusted based on actual show rates and patient value, not just lead volume.

Question 5

What should we do with Performance Max in a multi-location dental account?

Accepted Answer

According to groas, Performance Max was useful for display and YouTube impressions in markets where the group was opening new locations and needed brand awareness, but it served impressions outside each location’s service radius and cannibalized branded search terms. The article states its opaque reporting made it impossible to see which location benefited from PMax spend. The article recommends tighter controls rather than removal: radius targeting tightened to each location’s actual service area, brand exclusions enforced, and PMax budgets capped so they could not eat into Search allocation.